To obviate this difficulty, let new milk stand from four to six hours, take the top off, reduce one-half with hot water; to one pint add one teaspoonful of sugar of milk and one grain of phosphate of lime. When the child is from three to five months old, oatmeal, barley or bran gruel can be added.
Children have not sufficient secretion of saliva to convert starch into sugar. Therefore never use arrowroot or corn starch; these do not digest in the stomach, and intestinal derangement is likely to follow. Bran or barley gruel furnishes phosphates, which are essential to stimulate digestion.
Microscopical examination of the artificial foods prepared and sold for infants, proves many of them deficient in gluten and too abundant in starch to make them desirable nutriment. The following extract from “Playfair’s Midwifery” explains the
“Causes of mortality in hand-fed children.—Much of the mortality following hand-feeding may be traced to unsuitable food. Among the poorer classes especially there is a prevalent notion that milk alone is insufficient, and hence the almost universal custom of administering various farinaceous foods, such as corn-flour or arrowroot, even from the earliest period. Many of these consist of starch alone, and are therefore absolutely unsuited for forming the staple of diet, on account of the total absence of nitrogenous elements. Independently of this, it has been shown that the saliva of infants has not at first the digestive action on starch that it subsequently acquires, and this affords a further explanation of its so constantly producing intestinal derangement. Reason, as well as experience, abundantly proves that the object to be aimed at in hand-feeding is to imitate as nearly as possible the food which nature supplies for the newborn child, and therefore the obvious course is to use milk from some animal, so treated as to make it resemble human milk as nearly as may be.
“Artificial human milk.—An admirable plan of treating cow’s milk, so as to reduce it to almost absolute chemical identity with human milk has been devised by Professor Frankland, to whom I am indebted for permission to insert the receipt. I have followed this method in many cases, and find it far superior to the usual one, as it produces an exact and uniform compound. With a little practice nurses can employ it with no more trouble than the ordinary mixing of cow’s milk with water and sugar. The following extracts from Dr. Frankland’s work will explain the principles on which the preparation of the artificial human milk is founded: ‘The rearing of infants, who can not be supplied with their natural food, is notoriously difficult and uncertain, owing chiefly to the great difference in the chemical composition of human milk and cow’s milk. The latter is much richer in casein, and poorer in milk-sugar than the former, whilst asses’ milk, which is sometimes used for feeding infants, is too poor in casein and butter, although the proportion of sugar is nearly the same as in human milk. The relation of the three kinds of milk to each other are clearly seen from the following analytical numbers, which express the percentage amounts of the different constituents:
| Woman. | Ass. | Cow. | |
|---|---|---|---|
| Casein | 2.7 | 1.7 | 4.2 |
| Butter | 3.5 | 1.3 | 3.8 |
| Milk-sugar | 5.0 | 4.5 | 3.8 |
| Salts | .2 | .5 | .7 |
These numbers show that by the removal of one-third of the casein from cow’s milk, and the addition of about one-third more milk-sugar, a liquid is obtained which closely approaches human milk in composition, the percentage amounts of the four chief constituents being as follows:
| Casein | 2.8 |
| Butter | 3.8 |
| Milk-sugar | 5.0 |
| Salts | .7 |
The following is the mode of preparing the milk: Allow one-third of a pint of new milk to stand for about twelve hours, remove the cream and add to it two-thirds of a pint of new milk, as fresh from the cow as possible. Into the one-third of a pint of blue milk left after the abstraction of the cream, put a piece of rennet about one inch square. Set the vessel in warm water, until the milk is fully curdled, an operation requiring from five to fifteen minutes, according to the activity of the rennet, which should be removed as soon as the curdling commences, and put into an egg cup for use on subsequent occasions, as it may be employed daily for a month or two. Break up the curd repeatedly, and carefully separate the whole of the whey, which should then be rapidly heated to boiling in a small tin pan placed over a spirit or gas lamp. During the heating a further quantity of casein, technically called ‘fleetings,’ separates, and must be removed by straining through muslin. Now dissolve 110 grains of powdered sugar of milk in the hot whey, and mix it with the two-thirds of a pint of new milk, to which the cream from the other third of a pint was added, as already described. The artificial milk should be used within twelve hours of its preparation, and it is almost needless to add that all the vessels employed in its manufacture and administration should be kept scrupulously clean.
Any babe can be fed from the first with a spoon, and in a few weeks it will drink from a cup or glass. When it seems necessary to use the nursing bottle the utmost care should be taken to keep it clean and sweet. Two bottles should be used alternately. The one not in use should be thoroughly rinsed, and then laid (without the nipple) in an earthen or granite dish, containing a solution of common soda. Let it remain there until needed, then rinse it well, and you may feel that it is in good condition. Cleanse the nipple by hand. Do not use the rubber tube.